Sample Essay: Critical Thinking On A Mental Health Article

“Time Trends in Autism and in MMR Immunization Coverage in California” an article in the Journal of the American Medical Association written by Loring Dales, MD; Sandra Jo Hammer, RN,PHN; Natalie J. Smith, MD,MPH discuss the correlation of the vaccine MMR (Measles, Mumps and Rubella) and the onset of Autism in children from 1980 to 1994.  This study was conducted in response to the belief that immunizations in general and the MMR immunization specifically is the central cause to the increase of the mental health disorder of Autism.

The study looked at the Kindergarten students in California that were born between 1980 and 1994 and their immunization records.  The immunization that was focused on was the MMR and it was given between 17 and 24 months of age.  The number of immunizations were tracked and compared to the number of children diagnosed with Autism and found that there were 44 cases of autism per 100,000 in 1980 and 208 cases of autism per 100,000 in 1994.

The authors of the study state the largest drawback to their study was not being able to talk to the students or their families to determine other factors that may have had an impact on the cause of the autism.  Concerns also about the heredity factor of the disorder were mentioned in the article.  These were all the elements that they were not privy to or able to investigate.  This writer agrees that the information is simply not known by the authors and could have a huge impact in their ability to make a solid conclusion with the collateral information.

Information is also lacking about the sex of the children being reviewed.  Concerns about the sex of the children should have been addressed.  The percentage of males with a mental health diagnosis of autism is higher than the female population.  One simply must question whether or not the numbers of females included in the statistics caused a faulty result of conclusion.  This is an area of concern as the conclusion of MMR immunizations not causing an increase of mental health diagnosis of autism in children from the years of 1980 to 1994.

Dr. Stephen Barrett, who operates the Quackwatch website that will address medical issues to determine if it is a legitimate medical conclusion and is supported by many other medical professionals in the particular field of medicine being discussed.  Dr. Barrett has looked into the claim that autism is caused by vaccines and all vaccines should be discontinued in children.  Dr. Barrett supports his conclusion that immunizations as a whole and MMR specifically does not cause autism to develop in children.  Dr. Barrett’s article included studies which looked into the children’s medical history far more deeply than the study by Dales et al.  This supported the Dales et al conclusion by bringing evidence that has been missing in the first study.

The Immunization Safety Review Committee published a report of their studies and their conclusion also indicated that there is no correlation between the immunizations specifically the MMR vaccine and the occurrence of autism.  While this could certainly be a non-surprising conclusion of a study conducted by an immunization safety review committee; however, the findings in their study also supported the findings of the other two studies listed in this paper.  Each one brings another component to the original study that adds support and validity to the conclusion that would otherwise be questioned for the lacking elements.

A point that all three articles make that is extremely crucial in the findings of the lack of cases of autism being recorded.  What this mean is simply, there were millions of MMR vaccines given to both male and female children during these years and in 1980 only 44 cases were found in this study.  In 1994 there was only 208 recorded in this study.  If the MMR vaccine was the cause of the increase in autism, the numbers would have been substantially higher.

What this tells the researchers in all the studies is the cause of the onset of autism is not the MMR vaccine.  The reason for the belief of MMR immunizations causing autism is the time frame the immunization is given.  It is given between 17 and 24 months.  Additional studies have been conducted and referenced in Dales et al and Dr. Barrett articles of other causes of the onset of autism.  One fact that was mentioned numerous times is the age in which autism often manifests itself in outward symptoms parents are able to notice as something different or wrong with their child.  The abilities the child had been developing during their first year to year and a half begin to decline.  This time frame is also the time frame of the MMR immunizations.  However, the studies point out that even in children who did not have the MMR immunizations between the ages of 17 months to 24 months began demonstrating the symptoms of autism.

This was crucial in their findings that MMR does not cause autism or autistic symptoms to begin to manifest themselves.  It is unfortunate that the symptoms begin to manifest themselves after the child had shown great promise in their lives, but the MMR immunization is not the cause. Parents with children who have been diagnosed with autism are faced with a lifetime of struggles for themselves and their children.  While the MMR immunization is not the cause, nor the absence of the vaccine the cure for autism, this article demonstrates the need for finding the cause and possible cure or vastly more successful treatment for this disorder.  This writer believes that by ruling out one cause will enable the researchers to move forward to find the cause.  Causing ones child to face the risk of a serious disease simply due to the belief of it causing autism is tantamount to child abuse.

References

Barrett, Dr. Stephen. “Misconceptions about Immunization, Misconception #9:Vaccines Cause Autism” Quackwatch, Your Guide to Quackery, Health Fraud, and Intelligent Decisions. Accessed October 19, 2009. http://www.quackwatch.com/03HealthPromotion/immu/autism.html.

Dales, MD Loring; Hammer,  RN, PHN Sandra Jo; Smith, MD, MPH Natalie. “Time Trends in Autism and in MMR Immunization Coverage in California”. Journal of the American Medical Association. 2001: 285:1183-1185. Accessed on October 19, 2009.  http://jama.ama-assn.org/cgi/content/full/285/9/1183.

Immunization Safety Review Committee.  “Immunization Safety Review: Vaccines and Autism

Released”. May 14, 2004. Accessed on October 19, 2009. Board on Population Health and Public Health Practice. http://www.iom.edu/en/Reports/2004/Immunization-Safety-Review-Vaccines-and-Autism.aspx.